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Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.
On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.
A dilated fundus examination was performed demonstrating the following:
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Glaucoma
Case 2
Patient Presentation: A 68-year-old female was referred to an ophthalmology service due to decreased vision in her left eye. She had no past ocular history, but did not regularly see her optometrist. On assessment, her visual acuity was 20/25 OD 20/60 OS. IOP was 14 OU (on 0/0 classes or glaucoma medications). Fundus examination showed cup-to-disc ratios of 0.7 OD and 0.8 OS. ONH and RNFL OCT analysis is shown below.
Question: What features on OCT are concerning for glaucoma?
Ganglion cell complex analysis and macular cube OCTs are shown below.
Question: What additional features on OCT are seen?
Question: What is the most likely diagnosis?
Learning Objectives:
1. To differentiate between changes seen in glaucoma vs retinal vein occlusion.
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